Suicide attempts presenting to the emergency department before and during the COVID-19 pandemic: a comparative study

Abstract

Objective To compare and analyze the differences in the sociodemographic and clinical characteristics of suicide attempters who visited an emergency department (ED) before and during the coronavirus disease (COVID-19) pandemic.Methods This single center, retrospective study was conducted by reviewing the medical records of patients in the “self-injury/suicide” category of the National Emergency Department Information System who visited an ED between January 2019 and December 2020. We obtained information on baseline characteristics, suicide attempt, and disposition. Data were analyzed using the chi-squared test.Results A total of 456 patients were included. The number of patients visiting the ED for suicide attempts increased by 18.2% (from 209 to 247 cases) during the COVID-19 pandemic, and the ratio of suicide attempters to the total number of ED visits increased by 48.8% (from 0.43% to 0.64%, P<0.001). There were significant differences in methods of suicide attempt, endotracheal intubation, ED disposition, and the presence of mental illness. Drug overdose (42.1% vs. 53.4%) and gas inhalation (5.7% vs. 8.5%) increased, and hanging decreased (6.0% vs. 2.0%) during the pandemic. Endotracheal intubation (13.9% vs. 5.7%) and intensive care unit admission (29.7% vs. 14.6%) decreased. More patients with the history of mental illness visited during the pandemic (54.0% vs. 70.1%).Conclusion Since the COVID-19 pandemic began, suicide attempts have increased in this single ED although the lethality of those attempts is low.

Factors affecting patients who attempted suicide in the emergency department due to the prolonged pandemic of COVID-19

“…The unexpected spread of COVID-19 and the rising distress in the community have led to a pandemic, which may eventually lead to an increasing trend in reported suicide attempts during the COVID-19 pandemic compared with similar pandemics worldwide. This is consistent with the results of previous studies [ 8 , 9 ]. A Japanese study [ 10 ] compared changes in suicide attempt rates by period and reported that there were no significant changes immediately after COVID-19; however, as the disaster situation increased, the suicide attempt rate peaked in the fall of 2020, followed by a downward trend.…”

The Impact of COVID-19 and Exposure to Violent Media Content on Cyber Violence Victimization Among Adolescents in South Korea: National Population-Based Study

“…Byeon [ 16 ] found that changes in economic status and deteriorated mental health during COVID-19 influenced the suicidal ideation of Korean adolescents. Similar to previous findings about isolation and suicide attempts [ 24 ], isolation during COVID-19 resulted in feelings of disconnection and increased anxiety, depression, and psychological stress among Korean adolescents, leading to increased suicidal ideation and suicide attempts [ 17 ]. Suicidal tendencies were particularly exacerbated in multicultural Korean adolescents when they were exposed to sexual intercourse, depressive moods, and unhappiness during COVID-19 [ 25 ].…”

“…Byeon [ 16 ] identified experiences such as depression, subjective stress recognition, loneliness, and changes in economic status due to COVID-19 as major factors influencing suicidal ideation among Korean adolescents. Being isolated during COVID-19 has made South Korean adolescents feel disconnected from each other and from the broader community; there has also been an increase in anxiety, depression, and other indicators of psychological stress, which has increased not only the frequency of suicidal ideation but also the number of suicide attempts [ 17 ].…”

An Evaluation of the Effect of the COVID-19 Pandemic Lockdown on Hanging Cases

“…In a study that evaluated suicide attempts during the COVID-19 pandemic, it was stated that a three fold decrease (6% vs. 2%) in hanging admissions was observed during the pandemic [16]. Despite there not being any observed statistical difference before and after the curfew between the number of hanging cases, an upward trend was seen in hanging cases after the lockdown in the UK [17].…”